[+e+] MRI THORACIC SP WO CONT

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HISTORY:  77-year-old with conti[+ nued back pain                  status post +]is a lot of paing pain medicationss.

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PROCEDURE:  MRI the thoracic spines was pe[-rformed the sagitta -]l T1, T2 and STIR as well as axial T1 and T2-weighted images.

COMPARISON:  Radiographs of the thoracic spine from 8/17/2009. technique.test 

FINDINGS:  Please note [-that the vertebral bodies labeled technique.test in the preliminary report Rolfe by 1 vertebral body likely due to typographic error. Multiple T2 hyperintense renal lesions are identified in which are low signal on T1-weighted images with largest in the right kidney measuring 7 cm in diameter. These could be assessed.
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Paraspinal soft tissues are otherwise it is grossly unremarkable.
There is mild anterior-] compression deformity of T3 and T4 without associated marrow edema which appear to be chronic. Anterior compression of the T4 vertebral body results in approximately 40 percent loss in height. They are no retropulsed fragments or central canal stenosis at this level.

There is irregularity of the [+superior endplate of T8 with a lesion which is high signal on T1 and T2-weighted images and low signal on STIR which could be a hemangioma.
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There is apparent compression fracture of T10 involving the inferior two-thirds of the vertebral body with posterior retropulsion of a bone or just fragments measuring 6 mm. There is edema within the soft tissues adjacent to this fracture. There is indentation of the thecal sac without evidence of cord compression.

There is severe compression deformity of L2 with up to 80 to 90 percent loss in height anterior aspect of vertebral body. There is also retropulsion of bone at this level measuring approximately 7.5 mm which indents the thecal sac however does not compress the cord. There is high signal in the L1-L2 disk level without significant erosion of the endplates.

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There is extensive marrow of+] heterogeneity with lesions seen within the C T6, T7, T8, T11, T12, L1 vertebral body.

There is apparent nerve sheath cyst at the T4-T5 level on the left as well as at the T12-L1 level in the left. With the degree lateral extent beyond the neuroforamen seen at these 2 levels other etiology such as schwannoma or neurofibroma be less likely etiology.

There is a T2 hyperintense lesion in the poster lateral aspect of the T11 vertebrae which extends into the pedicle.

There is no gross focal stenosis of the central canal or neuroforamina. No intra or extradural fluid collections or mass lesions are identified. There is no gross abnormal signal within the cord or focal cord lesion identified.

IMPRESSION:  The lesion discussed on the preliminary report appear to be one level higher than actual mapping which could be due to the typographical error. There are significant compression fractures of T10 and nail to with retropulsion of fragments as well as marrow edema and edema in the soft adjacent soft tissues which suggests they are acute raise the T10. There is extensive marrow signal abnormality multiple lesions which are high signal on T2 some of which could be hemangiomas. Metastatic disease is not excluded. This could be more fully evaluated with contrast-enhanced study.

[+Findings on this study were transmitt
ed to the emergency department as well as discussed with Dr. Peniak 08/20/2009 09:35 p.m. on NightShift radiologist Wendy Stiles, MD.+]